VIRGINIA REPUBLICANS who are blocking expanded health coverage for the poor and disabled aren’t just at war with Obamacare. They’re also engaged in a crusade against hospitals, hospital executives and the ability of the state’s medical establishment to provide sustainable health care.

The immediate cause of their ire is the effort by Gov. Terry McAuliffe to make good on his bedrock promise in last year’s campaign to expand Medicaid so that several hundred thousand needy Virginians would have health insurance. In the face of Republican intransigence, Mr. McAuliffe has hit the road to make his appeal at hospitals from Northern Virginia to the Kentucky border. This has driven GOP lawmakers in the House of Delegates, who insist that Virginia refuse billions of dollars in revenue from Washington to expand Medicaid, to a state of dyspepsia.

One Republican lawmaker, Del. Terry G. Kilgore of Scott, became so agitated when the governor visited a hospital in his southwest Virginia district last week that he fired off a nasty e-mail expressing his displeasure to a senior hospital executive who attended the event. Other hospital executives say that GOP lawmakers have accused them of greed and hinted at repercussions for their backing of Medicaid expansion.

Browbeating health officials may make Republicans feel good, but it doesn’t change the basic math. The fact is that Medicaid expansion would give the state an enormous economic lift, generate thousands of jobs and provide health-care coverage to at least 250,000 Virginians. In the process, it would sustain hospitals whose financial health depends on unlocking federal funding.

When Mr. McAuliffe visitedMary Washington Healthcare in Fredericksburg recently, Republicans issued a withering press release attacking him and the hospital, which they said wanted a “bailout.” According to the statement, the hospital had more than $185 million in the bank and a chief executive who earned nearly $900,000 last year.

Putting aside the irony of Republicans assailing an executive for being highly paid, the truth is that the hospital is in financial straits. It lost $30 million over the past two years and, having borrowed heavily to finance an expansion, is burdened by debt. Its $185 million in reserves represents less than half a year’s operating capital.

Like most hospitals in the state, Mary Washington has been hit hard by cuts in federal subsidies that Medicaid expansion was designed to offset. That math was upended when the Supreme Court ruled that states could opt out of taking the additional Medicaid dollars. If Republicans in Richmond continue to refuse the federal funding, Virginia hospitals, already hard-pressed, will be forced to make deep cuts — to emergency rooms, mobile health vans and obstetrics wards, to name a few.

The state’s health secretary, William A. Hazel Jr., a holdover from the Republican administration of former governor Gov. Robert F. McDonnell, has repeatedly warned the GOP about this. He’s been ignored. Republicans, bent on partisan warfare, are so determined to hand President Obama and Mr. McAuliffe a defeat that they are playing chicken with the health care of ordinary Virginians.

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